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JudyKol, January 21,  2020  4:40pm EST

Mitral Valve Regurgitation

Just got a call from the cardiologist's secretary saying they got the results of the echocardiogram and the Dr. put a special appoinment in for me tommorrow morning at 8:00 am.

I know it shows moderate 3+ Mitral Valve Regurgitation.

I am supposing he wants to talk surgery? What questions might I ask?

7 Replies
  • AmbassadorC
    AmbassadorC, January 21,  2020  6:30pm EST

    Hi Judy, 

    You most certainly have come to the right place as I have shared a post re the questions that I asked of my surgeon. It's best to be prepared so please feel free to use these as a guide with modifications to your specific condition. Best of luck to you with your upcoming visit. 

    Repost from December 5, 2016 - 
    You have been told by your cardiologist that "it's time" for surgery.  You think to yourself, now what? Your upcoming events related to family, work and social obligations flash before you and you try to negotiate time and ask, how soon do I need to have this?   The hardest part of "swallowing this pill" is that you wish it could be something other than the one thing that sustains your very being - the heart. To further complicate things, what if you have never had any other surgery, and this is your first experience undergoing major surgery?  Nervous anxiety, the fear of the unknown and "what if's" occupy your every moment from the time you are informed by your cardiologist that "it’s time" and the time you meet with your surgeon to discuss the procedure that is recommended.  Everything from how do I prepare for this, how do I share this with my family, my friends, my employer, to how will this affect all aspects of my daily living, and what is my surgeons experience, begin to swirl through your mind.
    For me, after developing a leaking mitral valve the time to repair the valve came within a short period of two years upon careful monitoring by my cardiologist over the course of several years. I was a candidate for the robotic minimally invasive repair but had the option to also have a traditional open heart incision. It was important to me, to discuss both procedure's advantages and disadvantages as well as the number of surgeries the surgeon has performed.

    Below is a checklist of questions to discuss with your cardiologist and team for when you are informed "the time has come."

    ♥Risks associated with the traditional open heart repair of the valve vs. the minimally invasive robotic repair?
    ♥In your professional opinion Dr. based upon a degree of medical certainty what advantages are there that outweigh the risks of this type of surgery, in your overall professional expertise?
    ♥Advantages of the traditional open heart repair vs the minimally invasive robotic repair
    ♥Dr. in your professional opinion, why do you prefer the traditional repair approach
    ♥Disadvantages of the traditional open heart repair vs the minimally invasive robotic repair
    ♥Dr. in your professional opinion why do you feel these are disadvantages?
    ♥Approximately how long, based upon your professional expertise, have you observed the repair to last? Is it possible that the repair will necessitate a replacement down the line?
    ♥Is there a more optimal time to have the surgery which will aid in a faster recovery: i.e. Summer vs. Winter (dry and sunny conditions vs snow, ice)
    ♥Based on my current state of the heart, what is your recommendation for how quickly it should be repaired?
    ♥How will you repair my valve? (With the ring or just a nip and tuck)
    ♥Will my body organs be cooled down while on the pump run to preserve them?
    ♥Percentage of people who you have operated on and what is their outcome?
    Post Surgery/Recovery:
    ♥What is the typical recovery time for someone in my age, current state of the heart?
    ♥How soon will I notice an improvement? I.e. will I still feel the palpitations? sluggishness? Lightheadness that I feel now?
    ♥Will I need to be on medications after the surgery, if so, what and how long? Lifelong vs temporary?
    ♥Risks of infection?
    ♥If so, what?
    ♥What signs should I be aware of to be considered an ER (other than the common sense ones) i.e. will be it apparent if my valve springs a leak?
    Diet/ Daily Functions:
    ♥Soonest I can get out of the hospital?
    ♥Special diet during recovery?
    ♥Any Lifelong alternations: Will l I be able to return to eating chocolate? wine? How will caffeine affect my new valve?
    ♥Will I need a catheter during recovery?
    ♥Will daily functions such as sneezing, coughing, bowel movements affect have an impact on the recovery?
    ♥I Have a hard time staying put, what is the recommended activity level for optimal recovery? i.e. Will I be sleeping allot, should I expect to be walking around the house being able to fold laundry and vacuum? To that extent, should I make any advanced preparations that would assist in the transition of recovery
    ♥How soon can I return to work:
    ♥How can I handle job stress?
    ♥Modified work schedule to transition be recommend?
    Life Overall:
    ♥What will be my prescribed method of monitoring the condition of the valve replacement?
    ♥Any Medications?
    Support during Recovery 
    ♥Any nurses or support groups to recommend for further questions?
    ♥Any books to read in advance of the surgery?


  • JudyKol
    JudyKol, January 21,  2020  6:45pm EST

    Wow, I will make modifcations and bring the questions. This is just amazing. Thank you for your support.

  • AmbassadorC
    AmbassadorC, January 22,  2020  7:35am EST

    My pleasure❣️ Very best of luck with your appointment. 

  • JudyKol
    JudyKol, January 23,  2020  8:56am EST

    So was told as someone also mentioned, they don't operate for moderate mitral valve regurgitation. Cardiolgosit thinks its functional due to the aFib and that it will not show up when in sinus so ordered another echocardiogram as I'm in sinus now. In the meanwhile he said to start the Flecainaide and will schedule me for an ablation. I've found an EP thanks to the recommendations of this forum (I had never heard of EPs up until three weeks ago!) On reading on the internet, I see they don't give you a general for the ablation and not sure sure I can lie still while a wire is put in my neck. Kind of freaking out.

  • NancyGroover
    NancyGroover, January 23,  2020  2:07pm EST

    I was definitely out for my ablation. I don't remember anything after commenting on the temperature of the room. My procedure lasted 7 hours!  That is very unusual. I have ranauds and will definitely ask for some modifications if I have to have another.  Cath labs are always kept very cold. Trust your EP and not the internet. I didn't have my catherization until after I had my mitral valve repaired with an open procedure. Catherization is definitely the way to go if you have an option. My catherization was done from my groin. Ask your EP or their PA lots of questions. I have found the Physician Assistants to be very helpful navigating this journey that we are in. Good thoughts coming your way. 

  • BeverlyRae
    BeverlyRae, January 23,  2020  2:27pm EST

    I have had several Afib ablations, always under general, and my recoveries were uneventful and yielded good results. Having a good EP is most important. Best wishes!

  • Larkspur
    Larkspur, January 23,  2020  2:43pm EST

    I am supposing he wants to talk surgery? What questions might I ask?

    They may or may not talk surgery at this stage--as insurance usually only pays for it if the regurgitaion is severe. But, aside from the other excellent suggestions you have received, ask whether you might be a candidate for a MitraClip--that is what I had. No open heart surgery, done entirely through the femoral vein in the groin, one night in the hospital and you are set to go! The only recovery for me was from the drugs used in anesthesia. But you have to have the right anatomical presentation for the MitraClip to be suitable. It used to only be approved for the "frail" but that is changing. You can read about it here: https://www.health.harvard.edu/blog/mitraclip-valve-repair-device-offers-new-treatment-option-for-some-with-severe-mitral-regurgitation-2019042416495

    I have had 3 echos since this device was placed last June and all show that the regurgitation is now minimal. The procedure is not available at all hospitals as it takes special training. It is usually done by an interventional cardiologist. Best wishes!

    P.S. I was evaluated at Cedars Sinai in LA which is rated as the 3rd best valve center in the country. The MitraClip was recommended for me by the head of cardio-thoracic surgery there, though the implantation was done by a cardiologist very experienced in placing them in my local city.

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